INDIAN RIVER COUNTY — County Attorney Alan Polackwich told commissioners a state bill for $1.23 million in Medicaid reimbursements is unclear and may be in error, based on county records. Over the past 10 years Indian River County has rejected some state claims for reimbursement, usually because the patient treated here was not a resident of this county.
“The person in charge of this checks each line of each bill we get from the state,” said Polackwich. “If the background information shows the person lives in another county, we deny the claim and the state has never challenged our denials.”
Under state law, counties are required to reimburse the state for 35 percent of certain Medicaid expenses provided to county residents.
That status quo was disrupted when Gov. Scott signed into law HB 5301 that requires counties to pay charges they have denied since 2001.
“It is not clear if the $1.23 million they say we owe is all of the claims we denied or just some of them,” Polackwich said. “The person in charge of this here at the county thinks it is all of the claims, which shocked me. I assumed there was a process in place at the state that reviewed denials and either accepted or rejected them.”
County Administrator Joe Baird said the state has acknowledged “huge computer errors” in its reimbursement billing, and Polackwich said the situation will be clearer after an upcoming but yet unscheduled meeting with the state agency in charge of collecting the money.
He said it is possible the county will be able to document the correctness of its reimbursement denials and the state will agree to accept much less than $1.23 million.
After the meeting between the state and county, the state will issue a certified amount the county owes on Aug. 1. The county will then have 30 days to dispute the amount or agree to pay 85 percent of it.
If the county disputes the bill it will become liable for 100 percent of the certified amount, minus any denied reimbursements it can document as correct and get the state to accept.
Any money “paid” will be deducted from state revenue sharing funds over a period of five years beginning in October, according to Polackwich.
“I don’t like it that the state is trying to bribe us with our own money,” said Commissioner Bob Solari of the 15 percent incentive for accepting the state’s certified amount. “It is morally wrong and makes me more likely to fight this.
“This is very much the state’s mistake and they are too lazy to fix it and they are trying to make us pay for it.
The Florida Association of Counties is filing a lawsuit against the state to challenge HB5301 and Indian River County has the option of joining that action.
“My inclination is to join the lawsuit,” Solari said.
Polackwich and Baird suggested postponing board action until after the meeting with the state, in hopes the discrepancy can be resolved or at least clarified so the county will have a better idea of the best way to proceed.
Commissioner Wheeler noted the county has sent letters to its state senators and representative asking why they voted for the bill but has not received any response.
The board instructed staff to send a follow-up letter asking why there has been no response and why legislators supported the bill while waiting for the clarification meeting with the state.
“I am disappointed we haven’t heard from our legislators,” Wheeler said. “If they voted for it they must have some reason.”
